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General NPI Number Information
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NPI Number | 1306948724
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Entity Type | Organization
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Legal Business Name | ELMWAY PHARMACY INC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 8245 BROADWAY
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City | ELMHURST
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State | NY
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Zip | 11373
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Country | US
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Telephone | 718-803-2288
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Fax | 718-429-4199
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Provider Business Mailing Address
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Address Line | 8245 BROADWAY
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City | ELMHURST
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State | NY
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Zip | 11373
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Country | US
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Telephone | 718-803-2288
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Fax | 718-429-4199
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Authorized Official
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Title or Position | V PRESIDENT
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Name | PHOEBE TSE
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Credential | RPH
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Telephone | 718-803-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 025339
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License Number State | NY
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